do insurers recognize natural medicine as a prescribed treatment when applying for disability benefits?
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if you stop taking medications prescribed by your doctor, and instead take vitamins, herbal remedies or try acupuncture, for example, you may risk having your disability claim denied.
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a growing number of canadians are turning to natural medicine as an alternative method of health care and healing. this is leading to a growing denial of disability claims as a result of using naturopathic doctors and natural medicine.
this trend of clients turning to natural medicine or alternative therapies as their choice of care in dealing with injuries and illnesses is presenting another set of excuses for insurers to deny legitimate disability claims, as they do not recognize natural medicine as a prescribed treatment. they want people to follow guidelines of their doctor, as standard medical protocols have to be followed.
when applying for short-term or long-term disability benefits, these key reasons are typically given by insurers to deny benefits:
- not following the guidelines of your medical doctor;
- not following standard medical protocols;
- missing medical appointments; and
- following the advice of a naturopath and natural medicine or other not approved prescriptions.
yet a high percentage of canadians are turning to natural or non-traditional supplements or treatments to optimize health or for pain relief.
according to a 2016 study by the fraser institute, more than three-quarters of canadians (79%) had used at least one complementary or alternative therapy sometime in their lives. among the provinces, british columbians were most likely to have used an alternative therapy during their lifetime (89%), followed by albertans (84%) and ontarians (81%).
according to the government of canada’s national and non-prescription health products directorate, natural health products include vitamins and minerals, herbal remedies, homeopathic medicines, traditional medicines such as traditional chinese and ayurvedic (east indian) medicines, probiotics, and other products such as amino acids and essential fatty acids.
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so if you stop taking medications prescribed by your doctor, and instead take vitamins, herbal remedies or try acupuncture, for example, you may risk having your disability claim denied. or if you opt to try massage therapy instead of going to a surgeon, this could also result in claim denial.
many disability claimants are told if they don’t follow the insurer’s prescribed plans, then there is a risk the insurer may deny or terminate their benefits on the basis of a policy violation. the naturopath profession is not recognized by the insurance industry as a valid medical option when dealing with a disability claim and in fact, some claimants are told if they had taken medicine from a medical doctor, their illness or injury would have healed and they would have been already back to work.
in ontario, there is case law that provides that a failure to follow physician-prescribed treatment is just one factor to consider when adjudicating a disability claim, but is not the only one. sometimes people have tried conventional treatment, including pharmaceuticals, and have had adverse reactions.
so there still should be visits to your family doctor and specialists, perhaps let them know what you are taking, and try to make them an ally. in some circumstances, maybe you can do both traditional and homeopathic treatments, side by side.
if your claim is denied, you may be offered the insurer’s internal appeal process, however, these internal appeals can drag on for a long time and are rarely successful.
you may find a better approach is to retain a disability lawyer to file a statement of claim and gather evidence in support of your case. sometimes, your case can be settled through a mediation process in a timely manner.
natural medicine and other alternative healthcare options represent a growing trend, but unfortunately, that trend is also leading to increased disability claim denials. getting a legal opinion can provide much needed guidance during what is typically a difficult time.
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nainesh kotak, is the founder of kotak personal injury law, a firm focusing on protecting their client’s rights to justice and obtaining the compensation their clients deserve. he also serves as the chair of the long-term disability section of the ontario trial lawyers’ association.
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